BLS OES Green Jobs BLS OES Green Jobs Form - Panel 2

P hase 2 Panel 2

Green Jobs Survey

O.M.B. No. 1220−0182

Expires 12/31/11

Please provide information only for this location even if you are a multi-location business and return the form in the envelope provided. Complete the form even if you do not have any green jobs or practices at your location. If you need help completing this form, please send an email to info@usdol.websrg.com, or call 1-800-341-3660. Please return the form within 15 days.

I

1

f the physical location address shown below is no longer correct, please provide corrections in the space provided.

Enter address corrections

here

ATTN:

Owner

Company Name Inc.

Report for:

1 Main St. Suite 111

Winooski, ST 11111

W

2

hat was the total employment at this location as of February 12, 2011?

I

Enter total employment here

Enter corrections here

nclude: Do Not Include:

•

Enter total employment here

For incorporated firms – paid owners, officers, and staff • For unincorporated firms – owners, proprietors, and partners

• Total number of full- and part-time paid workers • Unpaid family workers

• Workers assigned temporarily to other locations • Workers on unpaid leave

• Workers not covered by unemployment insurance

• Contractors and temporary agency employees not on your

Payroll

O

3

ur records show that your main products or services are related to those listed below. If they are not, please list your main products or services in the space provided and continue with the rest of the survey.

C

urrent product or service description:

R

Enter corrections here

enting consumer electronics equipment and appliances,

s uch as televisions, stereos, and refrigerators. Included in this

industry are appliance rental centers.

D

4

id your location use any of the following green technologies or practices?

Column A:

Please indicate in Column A whether this location has actively used the type of green technology or practice listed during the pay period including February 12, 2011.

Column B:

For any green technologies or practices used during that same pay period at this location, please indicate whether there were any employees at this location who spent any of their time involved in:

• researching, developing, maintaining, using or installing technologies or practices to lessen the environmental impact of their establishment, or

• training the establishment’s workers in these technologies or practices.

Please include employees on the establishment’s payroll. Do not include contract employees or consultants when completing Column B.

The types of employees to include are listed in Question 2 on Page 1.

					Column A	Column B
Item	Type of green technology or practice		Examples		Did your location …?	Did any of your employees …?
	Energy from Renewable Sources and Energy Efficiency
1	Generate electricity, heat, or fuel from renewable sources primarily for use within your establishment?			• Wind • Biomass • Geothermal • Solar • Ocean • Hydropower • Landfill gas • Municipal solid waste	 Yes  No	 Yes  No
2	Use technologies or practices to improve energy efficiency within your establishment?			• Energy Star rated appliances • Compact fluorescent lights • Motion detection lighting • Programmable thermostats • Cogeneration (combined heat and power)	 Yes  No	 Yes  No
	Greenhouse Gas Reduction and Pollution Reduction & Removal
3	Use technologies or practices in your operations to reduce greenhouse gas emissions through methods other than those listed in Items 1 and 2 above (renewable energy generation and energy efficiency)?		• Purchase and use of carbon offsets • Promotion and/or subsidy of alternative forms of transportation for employees, such as carpools, fuel efficient vehicles, cycling, or mass transit • Implementation of a telework program for employees		 Yes  No	 Yes  No
4	Use technologies or practices to either reduce the creation or release of pollutants or toxic compounds as a result of operations, or to remove pollutants or hazardous waste from the environment?		• Carbon monoxide • Sulfur dioxide • Chlorofluorocarbons (CFCs) • Nitrogen oxides • Chlorinated hydrocarbons • Herbicides or pesticides • Heavy metals • Radioactive contamination		 Yes  No	 Yes  No
	Recycling & Reuse, and Natural Resources Conservation
5	Use technologies or practices to reduce or eliminate the creation of waste materials as a result of your operations?		• Collecting and reusing or recycling waste • Managing wastewater • Composting solid waste • Remanufacturing		 Yes  No	 Yes  No
6	Use technologies or practices in your operations to conserve natural resources? Please do not include using recycled inputs in your production processes.		• Managing land resources • Managing storm water • Conserving soil, water, or wildlife • Implementing organic agriculture or sustainable forestry practices		 Yes  No	 Yes  No
	Other technologies or practices not included previously. Please describe.
7					Yes	 Yes  No
8					Yes	 Yes  No

Please complete Question 5. If you answered ‘no’ for all items in Column B, please enter a zero in Question 5.

P

5

lease provide the total number of employees who spent more than half of their time using green technologies or practices in the pay period including February 12, 2011.

• P

  Enter the number of employees here

  lease count each employee only once, even if they are included in Column B more than once.

• P lease do not include contractors or consultants working at your establishment that are not on your establishment’s payroll.

• If no employees spent more than half of their time on green activities enter zero.

If you entered 0 please complete Question 7 and you are finished. If you entered one or more employees please complete Question 6.

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6

hat are the occupations and wages of the employees reported in Question 5?

Complete for employees who spent more than half of their time in green activities in Question 5. Please provide a job title, brief description of duties, and the number of workers by wage category in the space provided. Report part-time employees at their hourly rate.																			A					B									C						D							E						F				G				H				I				J						K				L					Total
																	HourlyWages		under 9.25					$9.25 - 11.49									$11.50 - 14.49						$14.50 - 18.24							$18.25 - 22.74						$22.75 - 28.74				$28.75 - 35.99				$36.00 - 45.24				$45.25 - 56.99				$57.00 - 71.49						$71.50 - 89.99				$90.00 and over
																	Salary		under $19,240					$19,240 - 23,919									$23,920 - 30,159						$30,160 - 37,959							$37,960 - 47,319						$47,320 - 59,799				$59,800 - 74,879				$74,880 - 94,119				$94,120 - 118,559				$118,560 - 148,719						$148,720 - 187,199				$187,200 and over
Example: Job Title: Hydrologist
Job Description: Researches water usage and implements wastewater treatment plans																																							1																					2																						3
Job Title:
Job Description:

A

B

C

D

E

F

G

H

I

J

K

L

Total

Question 6 Continued Hourly Wages

under 9.25

$9.25 - 11.49

$11.50 - 14.49

$14.50 - 18.24

$18.25 - 22.74

$22.75 - 28.74

$28.75 - 35.99

$36.00 - 45.24

$45.25 - 56.99

$57.00 - 71.49

$71.50 - 89.99

$90.00 and over

Salary

under $19,240

$19,240 - 23,919

$23,920 - 30,159

$30,160 - 37,959

$37,960 - 47,319

$47,320 - 59,799

$59,800 - 74,879

$74,880 - 94,119

$94,120 - 118,559

$118,560 - 148,719

$148,720 - 187,199

$187,200 and over

Job Title:

Job Description:

Job Title:

Job Description:

Job Title:

Job Description:

Job Title:

Job Description:

Job Title:

Job Description:

Job Title:

Job Description:

If you need additional space, please copy this page and attach the completed page(s) to this form.

If done, please complete Question 7.

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7

hat is your contact information? For the person or persons who completed this form.

For Green Technologies and Practices Information: For Occupation and Wage Information:

Contact Name: _________________________________

E-Mail: ___________________________________________

Department:_______________________________________

Job Title:__________________________________________

Business Website: __________________________________

Phone number: (_______) __________ - ________________

Contact Name: _________________________________

E-Mail: ___________________________________________

Department:_______________________________________

Job Title:__________________________________________

Business Website: __________________________________

Phone number: (_______) __________ - ________________

Thank you for completing this survey.

Please return this form in the enclosed envelope to:

Attn: Bureau of Labor Statistics Green Jobs

Strategic Research Group

995 Goodale Blvd.

Columbus, OH 43212

Confidentiality Statement. The Bureau of Labor Statistics, its employees and agents, will use the information you provide for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. This report is authorized by law 29 U.S.C.2. Paperwork Reduction Act Statement. Your voluntary cooperation is needed to make the results of this survey comprehensive, accurate, and timely. We estimate that completing this form will take an average of 20 minutes. This estimate takes into account time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information. If you have any comments regarding this survey, including suggestions for reducing the burden, send them to the Bureau of Labor Statistics, Office of Occupational Employment Statistics, Paperwork Reduction Project, 2 Massachusetts Avenue, N.E., Room 2135, Washington, DC 20212. The OMB control number for this voluntary survey is 1220-0182 and expires on December 31, 2011. Without a currently valid number BLS would not be able to conduct this survey.

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